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AHA:美国心脏协会发表科学声明:健康文盲发病风险高,建议医生少用”行话“

2018-06-06 岱西 中国循环杂志

近日美国心脏协会(AHA)发布科学声明,指出健康知识文盲,也就是健康素养低,已成为老百姓有效预防心血管病的主要障碍。

近日美国心脏协会(AHA)发布科学声明,指出健康知识文盲,也就是健康素养低,已成为老百姓有效预防血管病的主要障碍。

这项声明通过回顾十余年相关研究,总结出其中所面临的问题:

1.  一半以上的健康知识文盲不知道血压160/100 mmHg是异常的,也使得控制高血压的可能性降低了1.8~2.7倍。

2.  健康知识文盲更可能吸烟,而且即使戒烟也有3倍可能复吸。

3.  健康知识文盲若有糖尿病,更有可能发生并发症,比如视网膜病变。对于促进患者沟通并疾病管理在线门户的使用,这一人群也有1.7倍的可能基本不用。

4. 健康素养不够的父母会有2倍可能认为已经超重的孩子依然体重正常。

怎样避免这样的遗憾,让自己有更多机会去健康地生活?这里有个重点就是提高自己的健康素养,学着去认识疾病、了解疾病。

这份科学声明主张应用由联邦卫生研究和质量机构创建的通用预防措施工具包。

“健康素养并不是患者单一的问题,而是医疗保健服务复杂性的结果。这就要求医务工作人员要加强改进工作方式,以方便患者,提高医疗质量。”声明撰写专家组组长,宾夕法尼匹兹堡大学医学院Jared W. Magnani教授指出。

工具包为医务人员推荐的策略包括:

避免医学行话,用图片作为示意工具;

建立容易理解的表格、知情同意书和小册子;

改善患者随访,并开通电话;

要求患者出示所有用药,以便能更好评估患者的药物依从性和用药安全性;

要考虑到患者的文化背景、风俗习惯和宗教信仰;

把患者与专家支持、病例管理和社区资源联系起来。

“我们应该让患者很好地了解他们的疾病和治疗。”Magnani强调。

否则这些人会留下很多遗憾:

比如40余岁的他,做梦也没想到,能做100多个俯卧撑的身体,居然还发生了大面积心肌梗死。所幸的是,拨打120及时,挽回了一条性命。

57岁的她,虽然突然感觉一侧肢体不便并口角歪斜,但还是选择在家休息一夜静观其变,结果错过了最佳救治时间,至今步履蹒跚。

还有40余岁的她,打麻将很上瘾,坐着10小时不动,差点猝死,诊断为肺栓塞。

60岁的她欣喜地发现看过医生并服用华法林后,心悸等症状消失,于是果断停掉华法林。等待她的却是轮椅。

……

2016年中国居民健康素养监测结果显示,国民健康素养水平仅为11.6%。

健康素养,不仅仅指的是有阅读能力,还包括能对自己相关疾病的疑问提出问题,理解相关带有医学术语的文件,正确服用药物,并与医务人员及保险公司有效沟通。

“医患在防治心血管病危险因素、心脏病以及脑卒中方面的沟通也是极度不畅的。”Magnani指出。

他指出,许多患者并不理解他们拿到手的医学文件是什么意思,尤其是专业术语词汇。

比如患者虽然看到平板运动试验是阳性,但不知道这是个坏结果,或者医生告诉患者要少摄入钠,但患者却不知道如何识别和量化钠的摄入,甚至都不会看营养标签。

据悉,目前美国也只有12%的人有良好的健康素养,能够很好地利用医疗保健系统为自己服务。

而且健康素养不足不仅体现在少数族裔、老年人群、英语有限以及受教育程度和经济稳定性差的人群,即使受过高等教育,不了解医学术语,也超出其所经历,健康素养也可能很差或有限。

“近十年来,医疗保健、心脏设备、移动健康技术以及药物治疗的进展迈步较大,并且越来越强调医患共享决策制定以及患者自我报告结果。如果不能改善人群健康素养,这些进展就会受到羁绊,不能让更多人获益。”Magnani说。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1934149, encodeId=6a43193414944, content=<a href='/topic/show?id=a23ce9798fe' target=_blank style='color:#2F92EE;'>#美国心脏协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79798, encryptionId=a23ce9798fe, topicName=美国心脏协会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=50ba440, createdName=xirongguo, createdTime=Tue Apr 09 00:06:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267839, encodeId=e184126e8396c, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Jun 08 05:06:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322263, encodeId=791d32226328, content=还有一知半解的患者也十分可怕., beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7881672775, createdName=通通, createdTime=Thu Jun 07 15:10:29 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321962, encodeId=3244321962df, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Jun 06 15:44:35 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321956, encodeId=44bf32195692, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Jun 06 14:58:51 CST 2018, time=2018-06-06, status=1, ipAttribution=)]
    2018-06-08 zhaohui6731
  3. [GetPortalCommentsPageByObjectIdResponse(id=1934149, encodeId=6a43193414944, content=<a href='/topic/show?id=a23ce9798fe' target=_blank style='color:#2F92EE;'>#美国心脏协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79798, encryptionId=a23ce9798fe, topicName=美国心脏协会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=50ba440, createdName=xirongguo, createdTime=Tue Apr 09 00:06:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267839, encodeId=e184126e8396c, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Jun 08 05:06:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322263, encodeId=791d32226328, content=还有一知半解的患者也十分可怕., beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7881672775, createdName=通通, createdTime=Thu Jun 07 15:10:29 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321962, encodeId=3244321962df, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Jun 06 15:44:35 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321956, encodeId=44bf32195692, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Jun 06 14:58:51 CST 2018, time=2018-06-06, status=1, ipAttribution=)]
    2018-06-07 通通

    还有一知半解的患者也十分可怕.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1934149, encodeId=6a43193414944, content=<a href='/topic/show?id=a23ce9798fe' target=_blank style='color:#2F92EE;'>#美国心脏协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79798, encryptionId=a23ce9798fe, topicName=美国心脏协会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=50ba440, createdName=xirongguo, createdTime=Tue Apr 09 00:06:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267839, encodeId=e184126e8396c, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Jun 08 05:06:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322263, encodeId=791d32226328, content=还有一知半解的患者也十分可怕., beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7881672775, createdName=通通, createdTime=Thu Jun 07 15:10:29 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321962, encodeId=3244321962df, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Jun 06 15:44:35 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321956, encodeId=44bf32195692, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Jun 06 14:58:51 CST 2018, time=2018-06-06, status=1, ipAttribution=)]
    2018-06-06 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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    2018-06-06 smartxiuxiu

    0

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